Chiropractic Research: Our best defense

by Dr. David A. Jackson

The entire profession seems to be talking about the class action lawsuit filed against The Masters Circle, and most doctors realize that the accusations can have grave implications for all of us, particularly those who provide wellness, maintenance or preventive care.

I have worked closely with the leaders and clients of the Masters Circle over the years, and a finer group of chiropractors would be hard to find. They represent our profession in an upstanding way, and are huge proponents of subluxation based chiropractic and all it stands for.

A natural extension of the "short term fix" mentality reflected in the lawsuit is that we need to limit patients to fewer than 12 visits or give "progress" reports after each visit and discharge them once their symptoms are resolved.

You and I know how ridiculous that is and you would probably agree that long‑term care can have far‑reaching health and wellness benefits for all people.

But where's the proof?

If you were called into court tomorrow to testify that long‑term care is safe and effective, you would have to rely almost exclusively on anecdotal evidence or "conventional wisdom," rather than hard, scientific proof.

The research we have on the long‑term effects of chiropractic is skimpy at best.

There was a report in JMPT back in 2000 that found that the health habits of patients receiving chiropractic maintenance care were better overall than the general population. The study involved 311 chiropractic patients, 65 years and older, who had received chiropractic care for five years or longer.

When compared with US citizens of the same age, these subjects spent only 31% of the national average for health care services and enjoyed a 50% reduction in medical provider visits. (Rupert RL, Manello D, Sandefur R: "Maintenance care: health promotion services administered to US chiropractic patients aged 65 or older, Part II." Journal of Manipulative and Physiological Therapeutics 2000;23(1):10.)

A more recent research report, published in the Journal of Subluxation Research (JVSR), measured serum thiol levels in asymptomatic subjects and found that those subjects who had 52 to 312 weeks of chiropractic care fared best, with higher serum thiol levels than those subjects who had no or only short‑term chiropractic care. Serum thiols are a measure of human health status. It is a surrogate estimate of DNA repair enzyme activity, most notably poly ADP ‑‑ ribose polymerase or PARP.

Robert H. I. Blanks, PhD ‑‑ with co‑researchers Tonya L. Schuster, PhD and Marnie Dobson ‑‑ conducted the profession's largest, multi‑center study in the history of chiropractic, addressing health‑related quality of life. His paper, "A Retrospective Assessment of Network Care Using a Survey of Self‑Rated Health, Wellness and Quality of Life," presented the results of a study of 2,818 chiropractic patients who reported significant, positive perceived change in four domains of health, as well as overall quality of life. The patients, who received up to three years of chiropractic care, showed positive, progressive increases in health levels over the duration of care.

According to Blanks and co‑researchers, "These benefits are evident from as early as 1‑3 months under care, and appear to show continuing clinical improvements in the duration of care intervals studied, with no indication of a maximum clinical benefit." In other words, the longer they received chiropractic care, the better their health became.

Yet, much more research is needed to establish the long‑term impact of chiropractic care. We need to be able to swamp our opponents with a deluge of hard scientific results based on data collected from hundreds of thousands of people throughout the general population, who receive care from all types of chiropractors.

Do you think the lawyers would have been so quick to slap The Masters Circle with a lawsuit if they knew that we had overwhelming evidence that our general level of health can be enhanced through regular, long‑term chiropractic care ‑‑ and that we can continue getting healthier and healthier the longer we receive adjustments?

Such research will not only prevent this type of lawsuit, it will cause a mass migration of people away from medical treatment and into chiropractic offices. People will think of chiropractic as an integral component of health, just like nutrition and exercise. They'll want to see how healthy they could be, and keep striving to reach their maximum potential with the help of chiropractic. You won't have to advertise that you can treat low‑back pain or headaches ‑‑ the public will know, based on the publicity such research results would generate, that chiropractic could help their own bodies take care of that pain as well as strengthen their immune system and eliminate interference in their nervous system.

That's precisely the kind of research to be conducted by RCS (Research & Clinical Science), the private‑sector research company I recently founded with Dr. Blanks and JVSR Editor, Dr. Matthew McCoy.

Thanks to hundreds of doctors around the world who are expected to join RCS, we will soon have data from the largest sample of volunteers ever compiled in the history of chiropractic research (and quite possibly, the largest in the history of health care research!). We will collect initial data from thousands of people and for the majority of those who convert to paying patients, we will monitor their health progress over a minimum of 24 visits. We'll be able to have quantifiable data as to the impact of subluxation on human health, and the affect of long‑term chiropractic wellness care on numerous health variables.

Doctors will pay less than $10 a day to be part of the program for three years and will receive all equipment (including a complete computer system with monitor and printer, a PDA,  and proprietary software) support material such as forms, promotional and educational brochures...and training required to effectively incorporate the program into their normal office procedures.

At first, some people were skeptical that doctors of chiropractic would be willing to pay a fee in order to be part of a research program. They quickly realized, however, that doctors are astute enough to realize the very real benefits they'd enjoy by being part of this program, including:

*** the potential for a huge return on investment since similar research programs conducted by medical doctors often generate large numbers of new patients;

*** increased visibility within their community;

*** enhanced credibility as a scientific‑based chiropractic researcher;

*** improved and automated note‑taking capabilities built into the research software; and

*** the opportunity to contribute to ground‑breaking research that will help position chiropractic as the number one wellness approach available today.

It's research we as a profession need, and a program that you, as a field doctor, can use to build a successful, scientific, evidence‑based practice. I encourage all DCs to contact RCS to learn more about the program and how we can help each other achieve our mutual goals.

(Dr. Jackson is chief executive officer of Research and Clinical Science (RCS), a private sector research program exploring issues of subluxation correction and chiropractic care as they relate to health and wellness. Previously, he served as president of the Chiropractic Leadership Alliance and Creating Wellness Alliance and was owner/operator of several private practice offices in California and Idaho that specialized in high‑volume, family wellness‑based care. For more information on RCS, call 800‑909‑1354 or 480‑303‑1694, or visit the RCS website at www.rcsprogram.com.)